| NPI | 1518446129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: TX 38810) |
| Additional Taxonomies | 122300000X Dentist (Licence: NC 12597) |
| 122300000X Dentist (Licence: NJ 22DI02728700) | |
| Enumeration Date | 2018-08-14 |
| Last Update Date | 2023-02-16 |